Should I change the amount of cream I use since I’m having hot flashes and sleep disturbance?

Hi Catherine,

I am 58 and finally in menopause (no periods for 5 months). I have been using Natural Progesterone Cream successfully for several years, and was very pleased with it. Now I am having a lot of hot flashes and sleep disturbance. Should I change the amount of cream I am using? Since not having periods, I have been using 1/8 tsp. (I use a highly concentrated brand) for 3 weeks, then off one week.

Thank you,

Ruthie

Dear Ruthie,

Vasomotor symptoms, such as hot flashes and night sweats can best be described as a wave of heat passing through the body causing much discomfort and ‘flushing’ of the face, neck and chest, and occur in 85% of women entering menopause.

Although the hot flush is the most common symptom of menopause, there is a wide variation in its frequency among women in different parts of the world. In Europe and the United States, 70-80 percent of menopausal women experience hot flushes, in Malaysia 57 percent, in China 18 percent, and in Singapore 14 percent.

One of the most striking dietary differences among women in these areas is their intake of dietary soy protein and its phytoestrogen properties.

One of the ‘theories’ behind the cause of hot flashes and night sweats in industrialised countries is that our brain has become conditioned to high levels of estrogen. When this estrogen is withdrawn - as is the case when we come off HRT ‘cold turkey’ or as our estrogen levels drop significantly at menopause - our internal thermostat (the hypothalamus) begins “shouting”, trying to tell the pituitary to tell the ovaries to ovulate. The inability of the ovaries to respond is most likely due to a final depletion of eggs and their surrounding follicle cells.

This overactivity of the hypothalamus and pituitary signal begins affecting adjacent areas of the brain, which is often referred to as the vasomotor centre (that controls capillary dilation and sweating mechanisms), and women experience a hot flush.

It is argued that women experiencing perimenopause in third-world countries tend not to have such high levels of estrogen, therefore, changing hormone levels will not necessarily cause their internal thermostat to go into hyperdrive.

Research has shown that Asian women who consume large amounts of plant estrogens, especially the isoflavones in soy, have fewer menopausal symptoms and less osteoporosis and cardiovascular disease that women in the West. However, actualy studies conducted using isoflavones in the form of a pill vs. a placebo (a dummy pill) have, to date, proved inconclusive. So it’s up to you to try them out. See if they actually work for you.

In a study, menopausal women who added 20 grams of soy powder (about four tablespoons) a day to their diets reported reduced severity of hot flashes and night sweats.

Soy contains isoflavones, compounds that mimic the beneficial effects of estrogen without its risks. Soy is weaker than estradiol by factor of 1/1000. Estrogen replacement therapy raises the risk of breast and ovarian cancer. Soy powder, available in health food stores, can be added to juice, cereals and other foods.

Other ways to help ease hot flashes include the following:

• Stop smoking
• Limit your intake of caffeine, alcohol and spicy foods
• Try eating more Soy or Red Clover
• Take vitamin B6 & E supplements
• Acupuncture has also helped some women
• Participate in a regular moderate exercise program

There are women who report bouts of wakefulness at night-time after applying progesterone cream. This isn’t uncommon. If you believe this is the case for you, then apply cream first thing in the morning after showering to avoid sleeplessness of an evening.

Oh, and get your hormone levels checked out, Ruthie. Remove the guesswork before you consider increasing your dosage of progesterone cream.